Sydenham’s Chorea, a Rare Diagnosis Today

Abstract

Sydenham’s chorea is the most common cause of chorea
in childhood. The primary etiology is streptococcal post infection.
However, being an immune-mediated phenomenon,
other diagnoses should be excluded. As it is one of the manifestations
of rheumatic fever it is important to diagnose it
in order to start the treatment and prophylaxis of this disease.
The authors present a case of a 15-year-old male who
showed repetitive and stereotyped clonic motor tics after a
few weeks of streptococcal pharyngeal infection (with elevation
of anti-streptolysin O titer). From etiological investigation,
no relevant analytical, neuroimaging or electroencephalographic
alterations were registered. Transthoracic echocardiography
was normal. He began an antibiotic therapy in admission
to treat streptococcal infection and subsequently a
monthly ambulatory and secondary prophylaxis of rheumatic
fever. A theoretical review of this Sydenham’s chorea was
made, which is currently uncommon in developed countries,
given the low rate of streptococcal infections due to availability
of antibiotic therapy.